MEDICARE: LATOYA A TEMPLE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3747A0650X	Attendant Care Provider	24-017081-1	IN

General Provider Information

NPI Number	:	1003664657
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LATOYA A TEMPLE

Provider Business Mailing Address
First Line	:	9619 E 37TH PL
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46235-2104
Country	:	US
Telephone Number	:	317-619-5763
Fax Number	:

Provider Business Practice Location Address
First Line	:	9619 E 37TH PL
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46235-2104
Country	:	US
Telephone Number	:	317-619-5763
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2024
Last Update Date	:	05/08/2024

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Directions to “ LATOYA A TEMPLE ” Practice Location

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